Healthcare Provider Details

I. General information

NPI: 1457600611
Provider Name (Legal Business Name): TAMMERA LEE SCHNEIDER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2012
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 S LAYTON BLVD
MILWAUKEE WI
53215-1924
US

IV. Provider business mailing address

1555 S LAYTON BLVD
MILWAUKEE WI
53215-1924
US

V. Phone/Fax

Practice location:
  • Phone: 414-385-6600
  • Fax:
Mailing address:
  • Phone: 414-385-6600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number116339-030
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: